Related Experiment Video
Updated: Feb 6, 2026
Utilizing a Cranial Window to Visualize the Middle Cerebral Artery During Endothelin-1 Induced Middle Cerebral Artery Occlusion
Published on: February 22, 2013
Middle Cerebral Artery Pulsatility Index as Predictor of Cognitive Impairment in Hypertensive Patients
Salim Harris1, Teuku Reyhan1, Yetty Ramli1
1Department of Neurology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Insights
Middle Cerebral Artery (MCA) Pulsatility Index (PI) measured by Transcranial Doppler (TCD) can predict cognitive impairment in hypertensive patients. Higher MCA PI indicates a greater likelihood of cognitive decline.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Cognitive impairment is a growing global health concern linked to cerebrovascular disease, hypertension, and aging.
- Current gold standards for diagnosing vascular cognitive impairment (VCI) involve neurophysiology and MRI.
- Transcranial Doppler (TCD) offers a potential affordable alternative for VCI prediction using neurosonology.
Purpose of the Study:
- To evaluate the Middle Cerebral Artery (MCA) Pulsatility Index (PI) as a predictor of cognitive impairment in hypertensive patients.
- To compare MCA PI values between hypertensive individuals with and without cognitive impairment.
Main Methods:
- A cross-sectional study included 66 hypertensive subjects without macrovascular complications.
- Cognitive status was assessed using the Montreal Cognitive Assessment-Indonesia (MoCA-Ina).
- Transcranial Doppler (TCD) was used to measure bilateral MCA PI in both cognitive groups.
Main Results:
- A significant difference in MCA PI was observed between groups (p < 0.001), with higher PI in the cognitive impairment group.
- Elevated left MCA PI was more strongly associated with cognitive impairment than elevated right MCA PI.
Conclusions:
- Middle Cerebral Artery (MCA) Pulsatility Index (PI) serves as a viable predictor for cognitive impairment in hypertensive individuals.
- Neurosonological assessment via TCD can aid in identifying hypertensive patients at risk for VCI.
Abstract:
Background: Cognitive impairment is a manifestation of cerebrovascular disease regarding hypertension and other degenerative diseases which has become a global health issue due to increased life expectancy. Recently, the gold standard used for diagnosing vascular cognitive impairment (VCI) has required a combination of the neurophysiological approach and magnetic resonance imaging (MRI). The Neurosonological approach, involving measuring the pulsatility index (PI) of the middle cerebral artery (MCA) using Trans Cranial Doppler (TCD), can hopefully be used as an affordable alternative predictor of VCI in patients with hypertension. Methods: A cross-sectional study was conducted at the Outpatient Clinic of the Department of Neurology in Ciptomangunkusumo Hospital, Jakarta. Sixty-six hypertensive subjects with no macrovascular complication were selected and screened using the Montreal Cognitive Assesment-Indonesia version (MoCA-Ina) to determine their cognitive status. Subjects were categorized into two groups; subjects with scores ≥26 were classified as the normal cognitive group, while subjects with scores <26 were classified as the cognitive impairment group. Both groups then underwent TCD examination to determine bilateral MCA PI. Results: There was a significant difference between MCA PI in both groups; it was higher in the cognitive impairment group than normal group (p < 0.001). Subjects with an increased left MCA PI were more likely to suffer cognitive impairment than those with an increased right MCA PI. Conclusion: MCA PI can be used as a predictor for cognitive impairment in hypertensive subjects.
Related Concept Videos
01:38Cognitive Dissonance
01:28Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...